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1990, 10-32 Permit App: 90005618 Pellet Stove INFORMATION WORKSHEET • y � •PARCEL NUMBER: �3S/d - n, STREET ADDRESS: 5 r 3 O ' c$J to U t. - CITY/STATE/ZIP: 3pôkcLn1 LUQ,. Q 2z . SUBDIVISION: C=el -- 4 eo,_39Cr) BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: r OF BUILDINGS: $ OF DWELLINGS: WATER DISTRICT: OWNER: 1,_ikr rc+ J�-(-E,e Aamitn) PHONE: 56-1 4.22/ - (p ,,q5g 1. MAILING ADDRESS: \ 3(kni� CITY/STATE/ZIP: CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: Ins-tali/4 61, , • . . .....***************************************** *2 BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: - - CONTRACTOR: YIICNE: _ - - MAILING AI)D}2ESS: , ARCHITECT/ENGINEER: PHONE: - -_ MAILING ADDRESS: ` NEW: REMODEL: ADDITION:' ' CHANGE OF USE: I) Ei.L UNITS: OCCUPANT IOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. : REQUI NED UARKING:_ t HANDICAP: SEWER (Y/N) : IIYDRIi.HT: r- 10 _-_-. elle ."../11 2 CO:1TIt7,C'1UR LI C 4 :_ - - --- -- - •- \ CONTRACTOR: , / , �\ MAILING ADDRESS: • . ***:*******************************: ********************************** MECHANICAL INFORMATION CONTRACTOR LIC# : ; L •lthcr oR: i9'W ei,2ep& . 8tlY rcie- 3(c- - - `--- • coN•1 LI NG ADDRESS: E .74„1/.0(� .S/ /L GP hi-G_C:-=I S�o�/T/1C �/7 .'Ft02 06 - -, I.AIt ELECl'RIC: GAS: OIL: CCAL: WOOD: SOLAR: HEAT PUMP 0__ ENERGY CODE: WSEC: NWEC: UTILITY: SGC - APPROACH: PRESCRIPTIVE: POINT:-_ COMPONENT: SYSTEMS: x : , xxxx**********, , **** x**s**** *****x*x***** **x**********x*****xx******It* M Ed IAN I CAL FEES PLUIdBIl1G FEES TEM I)r.SCRI PTION__ ______ NUMBER OF- ITEM DESCRIPTION NUMBER OF ROCESS1NG FEE YES OR NO 1'ROC>"SSING FEE YES OR NO '.1(..71WORK SYSTEM101 LETS ,7)DS'ADVE/ - ,")I)S7UVE/I NSERT S1 NKS - WATER HEATERSHOWERS _-____ _ _ ..; HTG EQUI I'( 100,000 )BTU AS JITG EQUIP +100,000 ___ KITCHEN SI NLS __ _— - AS PIPING - € OF UNITS -_i-_ I)] SHWA_SHERS - __- —. - E11TUMP 1-100 BTU -- _-_____ GARBAGE DI SPOSAL _ -___ E.V1'PUMP 101-500 BTU CIIJTIIES % A SHER - -______ - EATI' 501-1000 .UMPI3'1•U UTI1,I 1'Y SI NKS _-_ _ ____- I_ATI'UMI.' 1001-1750 1311./ ELECTRIC WATER HEATERS _ ____ i:ATI'UMP +1751 I3TU - FIAJR hRAI NS 1:!-'RIG 1-100 13'1'U FIAOR SINKS :FP IG 101-500 13'1'U - 13AR SINKS -._ __ - .:I.1?IG 501-1 00 BTU ___ ROW DRAINS 'i:Fk1 G 101-1750 BTU1.A 'N SPRINKLER .FRIG 4 1750 I3TU SEWAGE E.JY,CFOR 1 R CONDITIONER 0-3 11P WATER SOFTENER ' H CONDITIONER 3-15 HP -- URINAL _ . • .1 R coNDITIONER 15-30 HP I)RINF..ING FOUNTAIN , I R CONDITIONER 30-50 IIP _ - .1 R CON DITI.O::f_'R +50 IIP • 'LNTIIJ+I'ING FANS - ;;APORAlelVE COOLERS •IiJliIRS DRYER .II.;E i,S I1)G - -- !NI.I STE() G1.S hPP!.I 1.'4CE • . -. _ - ,1EZ ft SI !.!:R 1 - 10000 cI l • - - - - - .